Ethical Leadership: Fostering an Ethical Environment & Culture ...

Part I: Introduction to IntegratedEthicsmaterials to help ethics consultants enhance their proficiency.Ethics consultation services handle both requests for consultation about specific ethicalconcerns and requests for general information, policy clarification, document review,discussion of hypothetical or historical cases, and ethical analysis of an organizationalethics question. By providing a forum for discussion and methods for careful analysis,effective ethics consultation:• promotes health care practices consistent with high ethical standards• helps to foster consensus and resolve conflicts in an atmosphere of respect• honors participants’ authority and values in the decision-making process• educates participants to handle current and future ethical concernsPreventive EthicsSimply responding to individual ethics questions as they arise isn’t enough. It’s alsoessential to address the underlying systems and processes that influence behavior. Everyethics program needs a systematic approach for proactively identifying, prioritizing, andaddressing concerns about ethics quality at the organizational level. That’s the role of theIntegratedEthics preventive ethics function.To support preventive ethics, the National Center forThe ISSUES ApproachEthics in Health Care adapted proven quality improvementmethodologies to create ISSUES—a step-by-step methodIdentify an issuefor addressing ethics quality gaps in health care. TheStudy the issueIntegratedEthics Toolkit provides practical tools andSelect a strategyeducational materials to support facilities as they apply theUndertake a planISSUES approach to improve ethics quality at a systemsEvaluate and adjustlevel.Sustain and spreadPreventive ethics aims to produce measurableimprovements in an organization’s ethics practicesby implementing systems-level changes that reducedisparities between current practices and ideal practices. Specific quality improvementinterventions in preventive ethics activities may include:• redesigning work processes• implementing checklists, reminders, and decision support• evaluating organizational performance with respect to ethics practices• developing policies and protocols that promote ethical practices• designing education for patients and/or staff to address specific knowledge deficits• offering incentives and rewards to motivate and reinforce ethical practices amongstaffEthical LeadershipFinally, it’s important to deal directly with ethics quality at the level of an organization’senvironment and culture. Leaders play a critical role in creating, sustaining, and changingtheir organization’s culture, through their own behavior and through the programs andactivities they support and praise, as well as those they neglect and criticize. All leadersmust undertake behaviors that foster an ethical environment—one that’s conducive toethical practice and that effectively integrates ethics into the overall organizational culture.